Summaries of health policy coverage from major news organizations

AAFP: 26 States Have Increased PCP Medicaid Reimbursement Rates

Only 26 states have temporarily increased Medicaid reimbursements for primary care physicians, as required under the Affordable Care Act, even though CMS issued final guidance on the increase in November 2012, according to the American Academy of Family Physicians, Modern Healthcare reports (Robeznieks, Modern Healthcare, 8/19).

Under the ACA, the federal government was expected to spend $11 billion to bring Medicaid reimbursement rates for PCPs in line with rates paid by Medicare beginning Jan. 1. The provision is meant to incentivize physicians to accept more Medicaid beneficiaries ahead of the ACA's Medicaid expansion, which is expected to result in an estimated 10 million new Medicaid beneficiaries in 2014 (California Healthline, 5/10).

However, the initiative got off to a slow start when CMS did not issue the final rule until November 2012. States had until March 31 to submit a plan to CMS, which then had 90 days to approve it or ask for revisions. At that point, states negotiate the increase with managed-care companies.

California is the only state still waiting on CMS final approval. AAFP says that all 50 states intend to have the new rates -- which are retroactive to Jan. 1, 2013 -- implemented by November (Modern Healthcare, 8/19).

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